摘要
目的本研究旨在探讨1990—2021年全球和中国女性人群归因于高体重指数(body mass index,BMI)的乳腺癌负担的现况和流行趋势,分析年龄、时期和出生队列因素对其的影响,并预测2022—2035年的发展趋势。方法基于2021年全球疾病负担数据库,采用Joinpoint回归模型分析流行趋势,年龄-时期-队列模型探讨年龄、时期和出生队列因素对疾病趋势的影响。使用自回归求和移动平均模型和指数平滑模型进行趋势预测分析。结果研究发现,1990—2021年中国女性归因于高BMI的乳腺癌负担增长率显著高于全球[死亡率平均年度变化百分比(average annual percent change,AAPC):2.20%vs.0.09%,P<0.001;伤残调整寿命年(disability-adjusted life years,DALYs)率AAPC:2.31%vs.0.14%,P<0.001]。尽管中国女性归因于高BMI的乳腺癌负担呈快速增长趋势,但各时间点的绝对水平仍低于全球:2021年中国年龄标准化死亡率(0.49/10万)为全球水平(0.95/10万)的51.6%,DALYs率(14.39/10万)为全球水平(21.83/10万)的65.9%。自回归求和移动平均模型与指数平滑模型预测显示,2022—2035年全球DALYs率持续上升,中国死亡率和DALYs率虽存在模型间差异,但均提示上升压力。结论高BMI对全球尤其是中国女性乳腺癌负担影响严重,需重视女性尤其年轻女性的体重控制,以减轻未来乳腺癌负担。
Objective This study aims to explore the current status and epidemic trends of breast cancer burden attributed to high body mass index(BMI)among females globally and in China from 1990 to 2021,to analyze the impacts of factors like age,period and birth cohort on this burden,and to predict the development trends from 2022 to 2035.Methods Based on the Global Burden of Disease(GBD)2021 database,the Joinpoint regression model was used to analyze the epidemic trends,and the age-period-cohort(APC)model was utilized to investigate the impacts of factors like age,period and birth cohort on disease trends.Additionally,the autoregressive integrated moving average(ARIMA)model and exponential smoothing(ES)model were employed for trend prediction analysis.Results The study found that the growth rate of breast cancer burden attributed to high BMI among Chinese females was significantly higher than that of the global average from 1990 to 2021(average annual percent change[AAPC]for mortality rate:2.20%vs.0.09%,P<0.001;AAPC for disability-adjusted life years[DALYs]rate:2.31%vs.0.14%,P<0.001).Despite the rapid growth trend of breast cancer burden attributed to high BMI in Chinese females,the absolute level at each time point remained lower than the global average:the age-standardized mortality rate of Chinese females(0.49/100,000)in 2021 was 51.6%of the global level(0.95/100,000),with the DALYs rate(14.39/100,000)being 65.9%of the global level(21.83/100,000).Predictions from the ARIMA and ES models revealed that the global DALYs rate would continue to rise from 2022 to 2035.Although there were differences in the mortality rate and DALYs rate of Chinese females between the two models,both models indicated upward pressure on these indicators.Conclusions High BMI has severe impacts on the breast cancer burden among females globally,especially in China.It is necessary to attach importance to weight control in females,particularly young females,and to reduce the future burden of breast cancer.
作者
丘冬琴
王利珍
张思明
范苑林
徐泰
QIU Dongqin;WANG Lizhen;ZHANG Siming;FAN Yuanlin;XU Tai(The People’s Hospital of Meizhou City,Meizhou,Guangdong 514000,China)
出处
《实用预防医学》
2025年第12期1449-1456,1464,共9页
Practical Preventive Medicine
基金
梅州市人民医院培育项目(PY-C2021037)
梅州市社会发展科技计划项目(2022C0301046)。
